Provider Demographics
NPI:1437228947
Name:CRUZ, DAVID W (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:W
Last Name:CRUZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1880 MARRON RD STE 102
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-1172
Mailing Address - Country:US
Mailing Address - Phone:760-729-3970
Mailing Address - Fax:760-729-0310
Practice Address - Street 1:1880 MARRON RD STE 102
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-1172
Practice Address - Country:US
Practice Address - Phone:760-729-3970
Practice Address - Fax:760-729-0310
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 21662111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor